Department of Urology, Dalhousie University, Halifax, NS, Canada.
Department of Urology, Dalhousie University, Halifax, NS, Canada.
Sex Med Rev. 2020 Oct;8(4):603-614. doi: 10.1016/j.sxmr.2019.12.002. Epub 2020 Jan 23.
Evidence for noninvasive management of Peyronie's disease contains many options with varying levels of evidence for each. Many first-line treatments recommended by urologists lack strong evidence for their use.
We summarize the noninvasive (oral medications, topical medications, traction, vacuum erection devices, extracorporeal shock wave therapy, intracavernosal injections and electromotive therapy) treatment options for Peyronie's disease and provide the levels of evidence for each.
A literature search of PubMed, EMBASE, Cochrane Library, and ClinicalKey databases was conducted, current up to April 2019.
For each treatment modality, we measured level of evidence, change in penile curvature, change in erectile function, the percentage of patients with improved angulation, and pain scores.
There is weak evidence to support the use of oral or topical medications. Higher levels of evidence exist for intracavernosal injections and extracorporeal shock wave therapy and may be helpful in certain patient populations.
The mechanisms behind Peyronie's disease are not fully understood. Penile injections provide the highest quality of evidence for noninvasive treatment. Ory J, MacDonald L, Langille G. Noninvasive Treatment Options for Peyronie's Disease. Sex Med Rev 2020;8:603-614.
关于非侵入性治疗 Peyronie 病的证据包含了许多选择，每种选择的证据水平都不同。许多泌尿科医生推荐的一线治疗方法缺乏其使用的有力证据。
我们总结了 Peyronie 病的非侵入性（口服药物、局部药物、牵引、真空勃起装置、体外冲击波治疗、海绵体内注射和电动疗法）治疗选择，并为每种治疗方法提供证据水平。
对 PubMed、EMBASE、Cochrane 图书馆和 ClinicalKey 数据库进行了文献检索，截至 2019 年 4 月。
对于每种治疗方式，我们测量了证据水平、阴茎弯曲的变化、勃起功能的变化、弯曲角度改善的患者比例以及疼痛评分。
有一些弱证据支持使用口服或局部药物。海绵体内注射和体外冲击波治疗的证据水平更高，可能对某些患者群体有帮助。
Peyronie 病的发病机制尚未完全清楚。阴茎注射为非侵入性治疗提供了最高质量的证据。
